Sunday, May 7, 2017

One year and one-half ago, Sheila Nevins (President of HBO
Documentary Films), asked a vital question of friend Perri Peltz. "Why
are so many young people overdosing. Is this drug abuse or something
else?" At the time the numbers were around 72 people-a-day passing out
on the streets, in buildings, in their homes, going into comas and dying
from a self-poisoning drug overdose.

For an investigative
reporter like Perri Peltz, the question had tremendous import. It seemed
that she and others she spoke to knew of someone's relative or child or
neighbor or friend or friend of a friend's family member who had
overdosed. So she decided to investigate and what she discovered was
profound. It upended any preconceptions of the demographic of
individuals who were overdosing and the families who were living with
the trauma and torment of wondering what they might have done to save
the lives of loved ones who had died.

The film
journey took Perri Peltz and her team into the homes of middle class
Americans. They were the antithesis of former stereotypes of drug users,
abusers and/or dealers. Interestingly, there was one factor in common.
Their addiction to opioids and "upgrade" into heroin began with a
hospital or doctor's visit prompted by a car accident, a physical fall, a
back injury or other pain related trauma. Their drug dealer was not a
scruffy, surreptitious, back alley miscreant. It was their medical
school educated doctor/general practioner who believed Purdue Pharmaceuticals'
aggressive promotional campaign that narcotic painkiller OxyContin
because of its time release design was not addictive, but in its new
form could be used to safely eradicate pain and allow individuals to
function in their complete capacity of wellness.

Nothing was or is
farther from the truth. In a 2007 settlement Purdue Pharma executives
admitted culpability and pleaded guilty to "misbranding" or not
appropriately warning users of the deleterious addictive properties of
OxyContin: made of the pure narcotic oxycodone, that contains a large
amount of the opiate in each tablet because of the time-release design. Did sales representatives and executives gauge the risk-reward ratio?
Did they consider that by the time doctors and families of patients
realized the unrelenting addictive properties of OxyContin and sued, the
company could still be ahead of the game, reaping tremendous profits
after any monetary settlements? Perhaps not, though this has indeed been
the case.

The product was heavily marketed for six years. In 1996 alone, annual sales reached $1 billion.Perhaps profit
wasn't a motive after all, and the promotion that led to the incredible
drug sales was not an intentional move by the company to addict and
endanger users. However, with the over-prescription of opioids by
doctors and the increase of opioid overdose deaths to epidemic
proportions, that is a moot point. People are dying of self-poisoning.
And this very important film that aired on HBO Monday evening, 1 May,
may give those who see it pause, if/when their doctor attempts to
over-prescribe an opiate like Oxycodone (such as OxyContin®) or
Hydrocodone (such as Vicodin®).

Peltz removes any notion that
opioid addiction that morphs to heroin addiction happens to "the other
guy or gal." With a clear, cogent and unremitting perspective, she
identifies four families who were tragically and fatefully seduced by
events that appeared to be benign. A daughter (who was a wife and
mother) had kidney stones and was in terrific pain. She gave her
medications to her sister who became addicted as she herself became
addicted. A beautiful wife and mother in her forties was prescribed
opioids after an initial hospital visit; she became addicted. A son was
prescribed opioids after surgery to remove a cyst; he became addicted. A
daughter was prescribed opioids after she fell and had hip and back
pain; she became addicted.

In each instance, Peltz
follows family members as they discuss the growing arc from doctor to
over-prescription to ending prescription to "graduation" into seeking
more and more pills. In four instances out of the five patients,
individuals moved into heroin addiction when the prescriptions stopped.
Heroin delivers the same effects and it is cheaper. In the instance of
the beautiful wife and mother (the husband eventually had to divorce
her), her addiction prompted her to physically injure herself to obtain
opioid prescriptions from various doctors who complied with her
persuasive pleas for narcotic painkillers.

With heartfelt empathy
Peltz examines each of the stories using family and medical testimony,
interviews, family photographs and videos, and poignant discussions. She
shows how the families were sideswiped into awareness that a nefarious
drug was in their midst and it had taken over the soul, body and mind of
their loved ones. Though in each instance there was rehabilitation
numerous times, there was also relapse.

Only in one instance that Peltz
illuminates, is the individual now on the road to recovery and there is
light at the end of the long tunnel of addiction. However, the other
four patients who began on prescriptions of opiates never were released
from the narcotic's hold over them. They poisoned themselves as they
attempted to satisfy the great hunger that the opiate increasingly
inured them to. They died and are mourned. And this film tells their
story in the hope of preventing one more death from opiate overdose.

In
a Q and A after the film screening, Dr. Andrew Kolodny (Co-Director of
Opioid Policy Research Collaborative Brandeis University), Gail Cole
(film subject and co-founder, Hope and Healing After an Addiction Death)
and others discussed that because of its incredibly addictive
side-effects, OxyCotin and other opioids must be prescribed
circumspectly. Their most effective use is at end-of-life or other
long-term pain conditions. Such examples they gave are unlike the
prescription examples for the patients identified in the film who became
addicted, then overdosed and died.

Peltz reveals in the title and
throughout the film that doctors' inappropriate over-prescription is a
hazard. The probability of over-prescription leading to possible
self-poisoning by patients along a journey of addiction should not be
risked or even entertained. This was further given credence to the
announcement Peltz made after the World Premiere of Warning: This Drug May Kill You, that the epidemic
numbers of opioid overdose are now higher than 91 deaths-a-day.

This
is a monumental film that touches all of our lives whether we
recognize it or not. With knowledge comes power and the ability for
patients and families to question their doctors about over-prescription
of opiates, if the occasion arises. Doctors are also becoming aware of
the epidemic and are over-prescribing much less. Advocacy and support of
families who are struggling up the long hill of a family member's
opiate addiction is an imperative.